COMMENTARY

Don't Underestimate the Risk for Hypoglycemia

Howard H. Moffet, MPH; Andrew J. Karter, PhD

Disclosures

August 15, 2013

Diabetes Drugs: Too Much of a Good Thing?

Our success in treating diabetes is one of the most powerful examples of the benefits of modern medicine. These scientific advances have helped millions of patients live longer, healthier, and more fulfilling lives. Studies show that patients who receive proper care for type 2 diabetes, the most common form of diabetes, increasingly can expect to live almost as long as those who do not suffer from the condition.[1]

Unfortunately, a surprisingly common and potentially fatal threat is emerging for the nearly 10% of Americans living with diabetes. Although diabetes medications are effective in regulating blood sugar to reduce the risk for future complications, they introduce their own set of risks. The most common adverse effect is hypoglycemia, which is even more serious than once thought.

Our recent study, conducted at Kaiser Permanente with colleagues from the Yale School of Medicine and the University of Chicago,[2] found that diabetes patients often experience severe hypoglycemia, regardless of whether their diabetes is well controlled or not. These findings, based on nearly 10,000 adult patients with type 2 diabetes, challenge the conventional wisdom that hypoglycemia is primarily a problem among patients with low average blood sugar levels.

Overall, more than 10% of patients experienced severe hypoglycemia during the year of the study, and it also commonly occurred in patients with high average blood sugar levels.

These results warrant serious consideration for clinicians who treat the disease. The symptoms of hypoglycemia are typically mild and temporary, including feeling lightheaded or shaky, hungry, or mentally confused. But at its worst, severe hypoglycemia is a life-threatening condition requiring immediate medical attention.

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